Healthcare Provider Details

I. General information

NPI: 1891729653
Provider Name (Legal Business Name): VICTOR GEORGE ETTINGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 TRUXTUN AVE STE 100
BAKERSFIELD CA
93301-3602
US

IV. Provider business mailing address

2215 TRUXTUN AVE STE 100
BAKERSFIELD CA
93301-3602
US

V. Phone/Fax

Practice location:
  • Phone: 661-840-9270
  • Fax: 661-864-7848
Mailing address:
  • Phone: 661-840-9270
  • Fax: 661-864-7848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberG23420
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: